title: Effectiveness of Systems Training for Emotional Predictability and Problem Solving (STEPPS) for borderline personality problems in a 'real-world' sample: moderation by diagnosis or severity?
abstract: BACKGROUND
  Systems Training for Emotional Predictability and Problem Solving (STEPPS) is a group treatment for borderline personality disorder (BPD). Two prior randomized controlled trials (RCTs) have shown the efficacy of this training. In both RCTs, patients with borderline features who did not meet the DSM-IV criteria for BPD were excluded, which were many. We investigated the effectiveness of STEPPS in a sample representative of routine clinical practice and examined whether DSM-IV diagnosis and/or baseline severity were related to differential effectiveness.
  
  
  METHODS
  Patients whom their practicing clinician diagnosed with BPD were randomized to STEPPS plus adjunctive individual therapy (STEPPS, n = 84) or to treatment as usual (TAU, n = 84).
  
  
  RESULTS
  STEPPS recipients showed more improvement on measures of general and BPD-specific psychopathology as well as quality of life than TAU recipients, both at the end of treatment and at a 6-month follow-up. Presence of DSM-IV-diagnosed BPD was not related to differential treatment effectiveness, but dimensional measures of symptom severity were; STEPPS was superior to TAU particularly in patients with higher baseline severity scores.
  
  
  CONCLUSIONS
  The findings show the effectiveness of STEPPS in a 'real-world' sample, and underscore the importance of dimensional versus categorical measures of personality disturbance.
authors.affiliation: Lentis, University Medical Center Groningen, Groningen, The Netherlands. eh.bos@lentis.nl
authors.forename: Elisabeth H
authors.initials: EH
authors.lastname: Bos
authors.forename: E Bas
authors.initials: EB
authors.lastname: van Wel
authors.forename: Martin T
authors.initials: MT
authors.lastname: Appelo
authors.forename: Marc J P M
authors.initials: MJ
authors.lastname: Verbraak
mesh_terms: D000328:Adult; D001883:Borderline Personality Disorder / Q000175:diagnosis* / Q000523:psychology / Q000628:therapy*; D004644:Emotions; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009426:Netherlands; D011340:Problem Solving; D011569:Psychiatric Status Rating Scales; D011615:Psychotherapy, Group / Q000379:methods*; D012720:Severity of Illness Index; D016896:Treatment Outcome